While several diseases can affect the periodontium, plaque associated periodontal diseases are by far the most commonly observed. These infectious diseases have been classified as gingivitis, chronic periodontitis, aggressive periodontitis, periodontitis associated with systemic disease, necrotizing periodontitis, periodontal abscess, and periodontic-endodontic lesions. Gingivitis and chronic and aggressive periodontitis comprise, by far, the most commonly observed periodontal conditions.
Periodontal diseases are classified, and a diagnosis is made, based on a comprehensive periodontal examination. Factors upon which these decisions are made include dental and medical histories, assessment of gingival inflammation (e.g., bleeding on probing), probing pocket depth, extent and pattern of alveolar bone loss, and presence or absence of signs and symptoms including pain, ulceration, and amount of observable plaque and calculus.
FIG. 1 shows a table 10 of common terminology used to provide a diagnosis for periodontal disease. The diagnosis designates the disease state extent as generalized or localized and severity as mild, moderate, or severe. Using this terminology, seventeen text-linguistic diagnoses are possible. Use of traditional text-linguistic terminology for a diagnosis of periodontitis based primarily on periodontal pocket depth, the extent and pattern of alveolar bone loss and bleeding on probing can be insufficiently precise to support clinical decision making or involvement of patients in successful management of their periodontal disease.
The traditional periodontal diagnoses (e.g., the text-linguistic diagnoses in FIG. 1) lack descriptive precision to accurately describe a periodontal disease state. For example, a diagnosis of generalized severe periodontitis can include a wide range of individuals extending from those who manifest only a few pockets that measure 6 mm or deeper in all sextants with mild to moderate bone loss to individuals with terminal disease. An individual with a specific diagnosis can undergo considerable improvement or deterioration in status without an accompanying change in diagnosis. The lack of a clear, concise, accurate nomenclature that is sensitive to small changes adversely affects a patient's understanding of their condition and poorly defines the urgency of their situation. Similarly dentists cannot know with precision the effectiveness of treatment when there is a broad range of meaning as occurs with text nomenclature.